Cardiopulmonary 2 2010

1 A physical therapist attempts to assist a patient to clear secretions after performing

postural drainage by coughing . What position would allow the patient to produce the
most forceful cough?
a) Prone
b) sidelying
c) Supine
d) Upright position

2 A 42-year-old female is admitted to a rehabilitation hospital to recover from a stroke.

During the examination, the physical therapist identifies significant sensory deficits in the
anterolateral spinothalamic system. Which sensation would be most affected?
a) Stereognosis
b) Kinesthesia
c) Graphesthesia
d) Temperature

3 A patient status post CVA with abnormal tone on the right side lies supine in bed. The
patient’s physical therapist discourages her from lying supine for long periods of time
because
a) the position can cause shoulder-hand syndrome
b) the position increases inferior subluxation
c) the position encourages tonic neck and labyrinthine reflexes
d) The position increases tone in the pectoralis

4 A physical therapist monitors a patient’s respiratory rate during exercise. Which of the
following would be considered a normal response ?
a) The respiratory rate declines during exercise as the intensity of exercise
increases
b) The respiratory rate does not increase during exercise
c) The rhythm of the respiration pattern becomes irregular during exercise
d) The respiratory rate decreases as the intensity of the exercise plateaus

5 A physical therapist designs a training program for a patient without cardiovascular

pathology. The therapist calculates the patient’s age - predicted maximal heart rate as
175 beats per minute. Which of the following would be an acceptable target heart rate
for the patient during cardiovascular exercise ?
a) 93 beats per minute
b) 122 beats per minute
c) 169 beats per minute
d) 195 beats per minute

6 A physician discusses a patient’s plan of care with a physical therapist. The patient is a
29 year old male that sustained deep partial -thickness burns to the anterior surface of
his upper legs . The physician discusses the possibility of discontinuing the topical
antibiotic silver sulfadiazine after identifying an irregularity in the patient’s laboratory
results. Which finding could be Most related to the use of silver sulfadiazine?
a) Leukopenia
b) Peripheral edema
c) Hyperanemia
d) Altered Ph balance

7 A male patient rehabilitating from cardiac surgery is monitored using an arterial line.
The primary purpose of an arterial line is to:
a) Measure right arterial pressure
b) Measure heart rate and oxygen saturation
c) measure pulmonary artery pressure
d) Measure blood pressure

8 A patient who suffered CVA four weeks ago, is beginning to show the ability to
produce movement patterns outside of limb synergies. According to Brunnstrom
approach, this patient is stage:
a) two
b) three
c) Four
d) Six

Questions 9 of 50
9 A female patient with left sided weakness and right sided facial paralysis is recovering
from a stroke. The patient is referred to speech and language therapy for assessment of:
a) speech
b) memory
c) swallowing
d) cognitive awareness

Questions 10 of 50
10 A 62 year old male patient with history of COPD, ( chronic obstructive pulmonary
disease) is admitted to the hospital for persistent cough and fatigue. The patient is
referred to physical therapy for rehabilitation. What tests will be performed?
a) Chest x-ray
b) Lung function test
c) Bone scan
d) Ultra sound

Questions 11 of 50
11 A female patient is admitted with exacerbation of asthma. What are the signs and
symptoms ?
a) Chest tightness, wheezing and cough
b) Fatigue, headache, and nausea
c) Pyrexia, hypertension and dizziness
d) swelling , inflammation and loss of function
Questions 12 of 50
12 A male 60 year old patient is diagnosed with recent cerebrovsacular accident with
sensory perceptual deficits. Which of the following nursing interventions is an
appropriate strategy to address the diagnosis?
a) Approach the patient from the unaffected side
b) Approach the patient standing in front
c) Approach the patient from the affected side
d) Approach the patient having identified his previous strengths

Questions 13 of 50
13 A patient with postpolio syndrome says that she is very tired and her muscles ache.
The therapist's best course of action regarding exercise is to:
a) decrease the intensity and duration
b) discharge her from the program
c) decrease the frequency to once a week
d) reschedule her exercise workouts for early morning

Questions 14 of 50
14 A female patient visits the general practitioner with the following complaints-- muscle
aches, jaundice, anorexia and diarrhea. Following clinical investigation, the diagnosis is
acute viral hepatitis A. How would hepatitis A be contacted ?
a) Unprotected sex
b) Poor hand washing after defecation
c) Alcohol
d) Drinking untreated water

Questions 15 of 50
15 A nurse is advising a patient on lithium medication in preparation for home discharge.
What would be most appropriate advice to give on lithium medication?
a) The importance of salt and liquids in the diet
b) The importance of taking missed doses
c) The importance of monthly blood tests
d) The importance of knowing when to stop the medication

Questions 16 of 50
16 A patient with Class 2 left sided congestive heart failure will demonstrate which
symptoms with exercise?
a) dependent edema
b) dyspnea with fatigue
c) chest pain
d) nausea

Questions 17 of 50
17 Mrs Jackson is a 39 year-old patient who is involved in a motor vehicle accident. She
has sustained internal injuries and is bleeding internally. Which type of shock would be
evident considering the diagnosis?
a) Hypovolemia shock
b) Cardiogenic shock
c) Vascular shock
d) Obstructive shock

Questions 18 of 50
18 A patient is admitted after receiving a bee sting while out walking. Patient’s records,
indicate highly sensitive to allergic reactions. The patient c/o of abdominal pain, anxiety,
diarrhea, nausea and vomiting. What other symptoms do you expect?
a) Abnormal heart rhythm, low blood pressure and rapid pulse
b) Hypertension, headache, blurred vision
c) Fatigue, pains in the limbs, ear ache
d) Dehydration, thirst loss of function

Questions 19 of 50
19 A 50 year-old male patient is admitted with chesty cough, and blood stained mucous.
The patient is referred to physical therapy for rehabilitation, the therapist notices the
patient has a history of COPD but he still smokes. What action would be most consistent
with the therapist’s objective:
a) Encourage breathing management
b) Encourage not to smoke
c) Encourage to wear nicotine patches
d) encourage to elevate feet when appropriate

Questions 20 of 50
20 A patient is admitted because of low hemoglobin values. The patient has a history of
pernicious anaemia. What signs indicate the diagnosis of anemia ?
a) Fatigue, shortness of breath, pins and needles.
b) Nausea , vomitting and dizziness
c) Tachycardia and hypotension
d) Vertigo, migraine and neckache

Questions 21 of 50
21 Sally Jones is a 25- year- old patient who presents with a pyrexia and productive
cough. The physician diagnosed her to have infectious pneumonia. What is the definition
of infectious pnuemonia?
a) Irritation of the bronchi
b) Inflamed airways
c) Fluid in the alveoli
d) Flu like symptoms

Questions 22 of 50
22 Mr Smith with a history of bronchitis and emphysema, is experiencing dyspnea when
exerting himself. What are the recognized signs of dyspnea?
a) Painful swallowing
b) Painful breathing
c) Inability to digest
d) Inability to speak

Questions 23 of 50
23 A male patient is scheduled for bronchoscope. He has been complaining ofpersistent
and unexplained cough. The patient has history of smoking. What are the potential
complications of a bronchoscope?
a) Epistaxis
b) Hypotension
c) Headache
d) Shortness of breath

Questions 24 of 50
24 What is the GOLD standard that is indicative of COPD?
a) FEV1/FVC ratio below 70%
b) increased total lung capacity
c) increased residual volume
d) decreased vital capacity

Questions 25 of 50
25 What is an acceptable oxygen saturation rate (SaO2) to maintain throughout the
exercise period?
a) 86%
b) 88%
c) 93%
d) 84%

Questions 26 of 50
26 A male patient 42-year-old is scheduled for angiography. The patient has a history of
coronary heart disease. How would you define the procedure of angiography?
a) Cardiac catheter- injecting a radiopaque contrast into blood vessels or heart
chambers.
b) Invasive procedure used to visualize the hearts coronary arteries, chambers,
valves and great vessels.
c) A balloon catheter is inserted into an artery of an arm or leg and gently guided
into a coronary artery
d) A surgical procedure in which a blood vessel from another part of the body is
attached to a coronary artery so as to bypass an area of blockage

Questions 27 of 50
27 Mrs. Jewels is a 52-year-old, admitted with central chest pain and pain radiating
down left arm. He was diagnosed with myocardial infarction ( MI ). What cardiac problem
accompanies myocardial infarction ?
a) Transient ischemic attacks
b) Palpations
c) Tachycardia
d) Angina pectoris

Questions 28 of 50
28 Jack Sims is a 69-year-old patient who underwent coronary artery bypass graft
(CABG). He has regular electrocardiograms (ECG) to monitor his recovery. Define the
function of ECG :
a) Recording of electrical changes in the heart
b) Reference to an irregularity in heart rhythm from a defect in the conduction
system of the heart.
c) An inerrant and typical electrical activity for the heart’s continuous beating
d) An electrical impulse monitoring the heart

Questions 29 of 50
29 The patient demonstrates moderate claudication pain in both legs following a 12
minute walking test. What is the best exercise program?
a) walk daily, 2-3 x/day
b) walk 2-3x/week
c) walk daily, once a day
d) walk weekly

Questions 30 of 50
30 During embryonic development, about 1% of the cardiac muscle fibres become auto
rhythmic cells that repeatedly and rhythmically generate action potentials. What is the
function of autorhythmic cells?
a) Conducting system
b) Systemic circulation
c) Pulmonary circulation
d) Coronary circulation

Questions 31 of 50
31 Your patient's x-ray reveals an infiltrate on the lower left thorax at the posterior base.
He complains of chest pain over the posterior base of the left thorax. You suspect this
patient has:
a) myocardial infarction
b) infected pleura
c) bronchitis
d) emphysema

Questions 32 of 50
32 Which of the following is an appropriate reason to terminate a maximum exercise
tolerance test for a patient with pulmonary dysfunction?
a) normal ECG monitoring
b) patient states he is tired
c) patient reaches age-predicted maximal heart rate
d) PaO2 decreases 20 mmHg

Questions 33 of 50
33 Appropriate criteria for determining the initial intensity of exercise for a patient who is
five days post-MI and is referred for inpatient cardiac rehabilitation does not include:
a) RPE less than 13 (6-20 scale)
b) HR less than 120 beats/min
c) HR resting plus 20 beats/min
d) systolic BP less than 240mmHg or diastolic BP less than 110 mg Hg

Questions 34 of 50
34 You are providing postural drainage for a patient. You noticed that the drainage has
decreased. What should you do to your plan of care?
a) Continue with your plan of care
b) Decrease the frequency of postural drainage regimen
c) Increase the frequency of postural drainage regimen
d) Discontinue postural drainage regimen

Questions 35 of 50
35 A 32 year-old female presents with physical tiredness, fatigue and apathy. The
physician diagnosed her with anemia and ordered blood to be tested for hematocrit.
What is the physician testing?
a) Testing for the percentage of RBC’s
b) Testing for blood loss
c) Testing for the presence of infection or allergens
d) Testing for homeostasis

Questions 36 of 50
36 Steven is a 46 year- old patient who has underwent cardiac surgery.
Electrocardiogram is ordered by the physician. What pathological changes would relate
to pericardial effusion?
a) Elevated QRS
b) Q wave
c) Depressed QRS
d) ST segment

Questions 37 of 50
37 Your patient's ECG shows gradual downward sloping of ST segment with a flat T
wave and shortened QT interval. Which medication can cause this?
a) Cardizem
b) Lexapro
 c) Digitalis
d) Baclofen

Questions 38 of 50
38 A female patient is referred by a physician for cardiac rehabilitation. She is post
cardiac surgery. Which symptoms will require cessation of exercise?
a) Confusion
b) Agitation
c) Headache
d) Non compliance

Questions 39 of 50
39 What is the purpose for obtaining Karvonen’s formula for heart rate reserve ?
a) Obtaining a appropriate range for training heart rate
b) Obtaining an appropriate demand on the heart during exercise
c) Obtaining exercise activities for range of motion
d) Obtaining an appropriate independence for self monitoring

Questions 40 of 50
40 You are treating a patient with pitting edema on (B) legs that is reversible with
elevation. What is the best intervention?
a) intermittent pneumatic compression
b) AROM
c) isokinetics
d) isometrics

Questions 41 of 50
41 You have a female 6- year old patient who presents with exacerbation of cystic
fibrosis. The physician refers the patient to physical therapy for bronchial drainage.
Define bronchial drainage.
a) Drainage techniques that use coughing and huffing to clear mucus from the lungs
b) Combination of breathing techniques to focus on the upper chest
c) Thumping on the chest and back for an hour
d) Encourage self education

Questions 42 of 50
42 Male patient 56-years-old , history of congestive heart failure. Patient examined by
physician and diagnosed with a pleural effusion. Patient prescribed a diuretic , what is
the potential effect of :
a) Improves the appetite
b) Increases sodium and water excretion
c) Increases fluid intake
d) Improves physical ability
Questions 43 of 50
43 John is a 62-year old patient with a history of bronchitis and emphysema. The nurse
documents "adventitious sounds, crackles heard with the stethoscope". What is the
definition of adventitious breath sounds with crackles ?
a) High pitched wheeze sounds
b) Soft and low pitched sounds
c) Bubbles or pop sounds
d) less audible sound

Questions 44 of 50
44 A patient is referred to physical therapy for postural drainage . What are the
guidelines for chest physical therapy ?
a) Treatment should be administered prior to eating or at least one hour after meals
b) Percuss and vibrate over each segment to be treated for at least 5-10 minutes
c) Therapy to be continuous for the length of time given
d) Treatment to be evaluated only when therapy has ended

Questions 45 of 50
45 According to the American College of Sports Medicine, absolute indications for
terminating an exercise include all of the following except:
a) onset of moderate to severe angina
b) acute MI
c) a drop in SBP with increasing workload
d) shortness of breath

Questions 46 of 50
46 All of the following increases the risk of coronary artery disease (CAD) except for:
a) Increased total blood cholesterol levels (> 200 mg/dL)
b) Increased levels of low-density lipoproteins (LDL > 130 mg/dL))
c) low concentrations of high-density lipoproteins (HDL < 40 mg/dL for men
d) high concentrations of high-density lipoproteins > 50 mg/dL for women)

Questions 47 of 50
47 Pulmonary edema is an abnormal accumulation of interstitial fluid in the interstitial
spaces and the alveoli of the lungs. What is the most common symptom of pulmonary
edema?
a) Nausea
b) Vertigo
c) Blurred vision
d) Dyspnea

Questions 48 of 50
48 Susan is a 46- year old patient with a history of breathing problems. The physical
therapist recommend inspiratory muscle training. How does this improve breathing ?
a) Increases ventilation capacity
 b) Improves swallowing
c) Improves rapid breathing rate
d) Improves coughing ability

Questions 49 of 50
49 What are the common side effect you will observe on patients on bronchodilators e.g.
Albuterol ( proventil )?
a) Headache and insomnia
b) Blurred vision
c) Chills and fevers
d) Dyspnea

Questions 50 of 50
50 Mrs Jones presents with a history of chronic obstructive pulmonary disease. Blood
taken from her artery showed high levels of carbon dioxide ( respiratory acidosis ). What
are other signs and symptoms do you expect to find?
a) purulent sputum
b) Blurred vision
c) Insomnia
d) Fatigue